Georgia hospices have been the site of several recent lawsuits involving hospice care. Georgia's hospices have experienced lawsuits over billing issues for patients who were not terminally ill, claiming insurance payments on ineligible patients, claiming insurance payments on services that were ineligible, submitting false claims, and charging Medicare for patients who did not qualify. The latest settlement in these cases involves a massive settlement in response to doctors receiving kickbacks. A kickback is a type of bribe that a person receives after the actions agreed to for the bribe have taken place. While these are more commonly heard-of in the realm of politics, they can sometimes be experienced in other fields, including medicine, as in this case.
The Compassionate Care Hospice Group (CCH Group) settled a case brought by whistleblowers who accused the company of providing kickbacks to doctors. The scheme involved five specific physicians referring patients for certain treatments available through Medicaid and Medicare. The doctors would receive payment for recommending these patients for those treatments. Specifically, the doctors would refer these patients as eligible for the hospice's services.
The settlement came after a lengthy investigation process. The government alleged that between April 2007 and April 2011, Compassionate Care Hospice Group paid an unknown amount to these doctors in order to secure payments from Medicaid and Medicare.
The settlement terms confirm that the claim remains as allegations only and the doctors involved will not be named. Compassionate Care Hospice Group was ordered to pay a $2.4 million settlement in order to resolve the allegations, much of which serves as both punishment for the Compassionate Care Hospice Group and restitution for Medicare's and Medicaid's losses.
The government has stated that they are working with the FBI and other investigative services to root out problems like this in the future. Currently, there is a larger case on-going involving AseraCare, a national company that operates several hospices nationwide, including a few in Georgia. Similarly, this case also revolves around false claims.
Can This Affect Patients?
Doctors accepting kickbacks can drastically change a patients treatment. Doctors are obligated to recommend and provide the best care and treatment for their patients. When doctors allow their judgment to be influenced by outside factors, such as funding or other influences, they place their patients in danger, which was the case in this instance. The hope is that the settlement will serve as a message to other providers or doctors in the future.